MEDICARE: MRS. ADRIANE HARRIS LCSW, CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149029283	IL

General Provider Information

NPI Number	:	1407210503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ADRIANE HARRIS LCSW, CADC

Provider Business Mailing Address
First Line	:	2875 W 19TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-3596
Country	:	US
Telephone Number	:	773-484-4293
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 W 35TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-1305
Country	:	US
Telephone Number	:	773-887-3335
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	06/18/2026

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